G04.81
G04.81: Other encephalitis and encephalomyelitis
Billable / specific codeICD-10-CM
G04.81 is a billable, specific ICD-10-CM code for other encephalitis and encephalomyelitis. It is valid for submission on a claim.
Check G04.81 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Noninfectious acute disseminated encephalomyelitis (noninfectious ADEM)
Excludes1 inherited from the categories above G04.81
A category’s note binds every code beneath it.
Excludes2 inherited from the categories above G04.81
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with G04.81
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
No CMS-HCC V28 category: this code does not change a RAF score.
Medicare coverage
G04.81 is named in 15 Medicare coverage policies: 15 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56380Billing and Coding: Rituximab
- A56551Billing and Coding: Visual Fields Testing
- A56718Billing and Coding: Intravenous Immunoglobulin (IVIG)
- A56771Billing and Coding: Special Electroencephalography
Alphabetic index entries that lead here
- Leukoencephalitis
- Rasmussen encephalitis
- Encephalitis›Rasmussen
- Encephalitis›specified NEC
- Encephalitis›suppurative
- Encephalomyelitis›specified NEC
- Meningoencephalitis›specified organism NEC
- Syndrome›Rasmussen
- Encephalomyelitis›acute disseminated›noninfectious
- Encephalitis›acute›disseminated›noninfectious
Code history
Unchanged in every release from FY2024 to FY2027.